How To Turn A Person In Bed

WHAT YOU SHOULD KNOW:

Sometimes, people who are sick, injured, or recovering from surgery cannot move in bed on their own. When this happens, it is important to turn a person to a different position at least every two hours. It is not comfortable to stay in one position for too long. Certain health problems may occur if a person is not turned often. Caregivers may tell you different ways to turn a person, depending on his injuries or health status.

AFTER YOU LEAVE:

Be sure to move a person in bed correctly:

  • You can prevent pain and injury for both the person in your care and for you if you practice good form. You can injure your arms, back, or other areas with a poor turning method. You should not try to turn a person by yourself.

  • Do not drag or pull the person because it can tear or shear skin. This can lead to pressure ulcers. Certain medical conditions can worsen if a person is turned incorrectly.

  • Breathing tubes, traction for broken bones, or other medical devices may require special handling as a person heals. Ask if the person requires special positions in bed.

What you should know when turning a person in bed:

  • Ask other people to help with the turn. Do this especially if the person weighs 200 pounds or more.

  • If the person is awake and aware, tell him what will happen during the turn. If he can move himself, tell him how he can help. Check for twisted, damp, or soiled bedsheets. Check if the person's skin is damp from sweat, wound drainage, or urine. Change the person's bedding if needed and you know how, or get help to change it.

  • The person's body must stay aligned (straight) during the turn. Keep the head and neck, torso, hips, and legs of the person in a line by moving together with helpers. Each helper should take care of a certain area, such as the head and neck, torso, or hips and legs.

  • Gather plenty of cushions before the turn. Pillows and cushions help keep a person in position and help prevent pressure ulcers. For example, you will need at least six pillows to keep a person on his side. Other cushions may support the feet, arms, and head. Remove pillows and cushions before the turn, and position them around the person after the turn.

  • Use a turning sheet or draw-sheet to protect the person's skin and make turns easier. This is an extra sheet secured on top of a regular bedsheet. It can extend from the patient's head to his ankles, or may extend from his shoulders to his knees. You also may be able to use a friction-reducing device with handles or pull straps to turn the person.

  • Adjust any tubes, drains, or medical devices before the turn.

  • If the bed is adjustable, raise the bed to elbow height to reduce the stress on your shoulders during the move. Make sure the head of the bed is flat for the turn.

  • If the bed has side rails, lower the rail on the side where you are standing before turning a person. Put the rail back up before moving to the other side of the bed and after the turn is complete.

How to turn a person in bed:

  • Cross the person's arms over his chest so they do not get trapped under his body during the turn.

  • You and your helpers will face the person on one side of the bed. Put a pillow between the person's knees.

  • You and other helpers should grasp the edge of the draw-sheet. Roll the edge of the draw-sheet you are holding close to the person you are turning. On the count of 3, you pull the draw-sheet toward you. Keep your movements smooth. Move to the other side of the bed with your helpers.

  • Each helper will reach over the person to grasp the rolled end of the draw-sheet.

  • On the count of 3, pull the rolled side of the draw-sheet so the person rolls toward you. This is called a logroll turn.

  • Adjust the head of the bed for comfort.

How to move a person up in bed:

A person slides down in bed over time, often when the head of the bed is raised. This can make breathing difficult. Follow these steps to move a person up in bed, unless caregivers give you different instructions:

  • Ask other people to help you. Ask your helpers to stand on the other side of the bed from you.

  • Place a pillow against the head of the bed to help prevent the person from hitting his head when you move him up.

  • Helpers on both sides of the bed roll the draw-sheet ends against the person's body. Help the person bend his knees to help with the move, if he can. Do not ask the person to use his elbows to help. This can lead to sore or injured elbows.

  • Each helper uses one hand to grasp the rolled draw-sheet next to the upper chest or back. Use the other hand to grasp the rolled draw-sheet next to the person's buttocks. Prepare for the move by standing with your feet wide and your knees bent. While you place one foot slightly forward, hold your elbows in.

  • Place your weight on your back foot. On the count of 3, all helpers move together to shift their weight onto their front feet. As they shift, all should lift the draw-sheet toward the head of the bed. During the move, the person pushes up with his legs, if he can.

  • Repeat the lift if the person needs to move higher in bed.

How to position a person on his back:

  • When a person is on his back, keep his backbone and legs straight.

How to position a person on his side:

  • Bend the knee of the leg that is not touching the bed. Place a pillow between the person's knees.

  • Place pillows or cushions along the person's back to keep him in position. A pillow under the arm not touching the bed can also help keep the body aligned.

  • If you have questions about how to position a person on his side, ask the person's caregiver.

How to position a person on his stomach:

  • Ask the person's caregiver if the patient should be moved to this position before moving him.

  • When a person is on his stomach, place his head to one side, with a folded towel or flat pillow underneath for comfort. A pillow placed under the stomach supports his back. Place the person's arms at his sides, with the legs straight and apart. Pillows under the lower legs keep the feet off the bed and help prevent pressure ulcers. His arms can be away from his sides and bent at the elbows.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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